Indiana University-Purdue University Indianapolis (IUPUI) / Gain-of-function mutations in the KIT receptor tyrosine kinase have been associated with highly malignant human neoplasms. In particular, an acquired somatic mutation at codon 816 in the second catalytic domain of KIT involving an aspartic acid to valine substitution is found in patients with systemic mastocytosis (SM) and acute myeloid leukemia (AML). The presence of this mutation in SM and AML is associated with poor prognosis and overall survival. This mutation changes the conformation of the KIT receptor resulting in altered substrate recognition and constitutive tyrosine autophosphorylation leading to constitutive ligand independent growth. As there are currently no efficacious therapeutic agents against this mutation, this study sought to define novel therapeutic targets that contribute to aberrant signaling downstream from KITD816V that promote transformation of primary hematopoietic stem/progenitor cells in diseases such as AML and SM. This study shows that oncogenic KITD814V (murine homolog) induced myeloproliferative neoplasms (MPN) occurs in the absence of ligand stimulation, and that intracellular tyrosines are important for KITD814V-induced MPN. Among the seven intracellular tyrosines examined, tyrosine 719 alone has a unique role in regulating KITD814V-induced proliferation and survival. Residue tyrosine 719 is vital for activation of the regulatory subunit of phosphatidylinositol 3-kinase (PI3K), p85α, downstream from KITD814V. Downstream effectors of the PI3K signaling pathway, in of leukemic cells bearing KITD814V with an allosteric inhibitor of Pak or its genetic inactivation results in growth repression due to enhanced apoptosis. To assess the role of Rac GEFs in KITD814V induced transformation, EHop-016, an inhibitor of Rac, was used to specifically target Vav1, and found to be a potent inhibitor of human and murine leukemic cell growth. In vivo, the inhibition of Vav or Rac or Pak delayed the onset of MPN and rescued the associated pathology in mice. These studies provide insight on mechanisms and potential novel therapeutic targets for hematological malignancies harboring an oncogenic KIT mutation.

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Die invasiven und metastatischen Eigenschaften vieler Tumore werden mit einer Veränderung im physiologischen Gleichgewicht der Matrix Metalloproteinasen (MMP) und ihrer spezifischen und unspezifischen Inhibitoren in Zusammenhang gebracht. Das Ziel dieser Dissertation war es, die Wirkung von Batimastat, einem synthetischen Inhibitor der MMP, auf hormonabhängige und hormonunabhängige Prostatakarzinomzellinien sowie auf das Tumorwachstum im orthotopen Tumormodell des Dunning Tumor (R3327) zu untersuchen. Methoden: Im Zellkulturversuch wurde die Wirkung verschiedener Konzentrationen von Batimastat untersucht und die Proliferation mit dem MTT Test gemessen. Die Induktion des orthotopen Tumors erfolgte durch Inokulation von MATLyLu Zellen in die Rattenprostata (Dunning Tumor der Copenhagen Ratte). 10 Tiere wurden nach Tumorinduktion täglich mit 30 mg/kg Batimastat durch intraperitoneale Gabe behandelt, 10 weitere Ratten erhielten nur das Vehikel. Zehn Kontrolltiere blieben unbehandelt. Der Effekt auf des lokale Tumorwachstum wurden durch Bestimmung des Tumorgewichtes nach 20 Tagen definiert. Results:Batimastat zeigte eine dosisabhänige Hemmung des Wachstums der Prostatakarzinomzellinien in vitro. Bei 4000 ng/ml kam es zu einer eindeutigen Hemmung des Zellwachstums. Im Tierversuch fand sich nach 20 Tagen in der Kontrollgruppe ein mittleres Tumorgewicht von 18.9 ± 5,4 g, in der Vehikelgruppe von 22.3 ± 4,3 g und in der mit Batimastat behandelten Gruppe von 11.1 ± 2,6 g. Im Vergleich zur Kontroll- und Vehikelgruppe, zeigte sich in der Batimastatgruppe ein signifikant geringeres Tumorgewicht. Zusammenfassung: Batimastat kann das Tumorwachstum in einem Standardtiermodell des Prostatakarzinoms vermindern. Der Dunning Tumor der Copenhagen Ratte ist ein zuverlässiges Tiermodell zur weiteren Untersuchung von synthetischen Inhibitoren der MMP. / Background: Increased concentrations of metalloproteinases are associated with the invasive and metastatic behavior of several human malignant tumors. Normally, enzymatic activity is tightly regulated by nonspecific mechanisms and specific inhibitors. The aim of this dissertation was to determine the potential of a synthetic metallproteinase inhibitor, batimastat, to show its in vitro effect on hormonedependent and hormoneindependent prostate cancer cell lines and its in vivo effect on tumor growth in orthotopic cancer (R3327 Dunning tumor) in rats. Methods: In vitro, a dose response curve of batimastat was generated over 5 days using the MTT assay. Prostate cancer was injected in vivo in male Copenhagen rats by inoculating R3327 Dunning tumor cells (MATLyLu) into the ventral prostatic lobe of 30 rats. Each of 10 rats received batimastat (30 mg / kg / body weight) or vehicle once a day by i.p. application beginning the day of cell inoculation. Ten rats remained untreated. The effect on local tumor growth was evaluated by measuring tumor weights 20 days after tumor cell inoculation. Results: Significant inhibiton of tumor cell proliferation in vitro occurred at 4000 ng / ml batimastat. After orthotopic cell inoculation, tumors grew to mean weights of 18.9 ± 5,4 g in the control group without treatment, to 22.3 ± 4,3 g in the vehicle group, an to 11.1 ± 2,6 g in the treated group. In comparison to the control group and to the vehicle group, tumor weights increased significantly less under treatment with batimastat. Conclusions: Batimastat is able to reduce tumor growth in the standard prostate cancer model. Using this model, activity against cancer progression of future inhibitory agents can be reliably assessed.

A qualitative research design and an ethno-nursing research method were used to identify cultural factors influencing Xhosa women's health seeking behaviours associated with breast lumps. Focus group interviews were conducted to obtain data. The research results revealed that these Xhosa women with breast lumps did not disclose some cultural factors which influenced their health seeking behaviours associated breast lumps. Registered nurses, sharing the same culture and language as the Xhosa women, revealed that Xhosa women with breast lumps sought treatment from traditional healers, prior to seeking medical care from the hospital and/or clinics. When they arrive at the hospital/clinics the breast lumps have often progressed to advanced ulcerated breast cancer, with poor prognoses and poor treatment outcomes. Xhosa women lacked knowledge about the management of breast lumps. Health promotion efforts should address this issue at Primary Health Care services in the Eastern Cape. / Health Studies / M.A. (Health Studies)

A qualitative research design and an ethno-nursing research method were used to identify cultural factors influencing Xhosa women's health seeking behaviours associated with breast lumps. Focus group interviews were conducted to obtain data. The research results revealed that these Xhosa women with breast lumps did not disclose some cultural factors which influenced their health seeking behaviours associated breast lumps. Registered nurses, sharing the same culture and language as the Xhosa women, revealed that Xhosa women with breast lumps sought treatment from traditional healers, prior to seeking medical care from the hospital and/or clinics. When they arrive at the hospital/clinics the breast lumps have often progressed to advanced ulcerated breast cancer, with poor prognoses and poor treatment outcomes. Xhosa women lacked knowledge about the management of breast lumps. Health promotion efforts should address this issue at Primary Health Care services in the Eastern Cape. / Health Studies / M.A. (Health Studies)